Fast 5 Speakers Reflect on What It Means to Empower Patients and Partners in Care

In July of 2022, radiology colleagues from around the world submitted topics for consideration to participate in this year’s Fast 5 presentation, an engaging, fast-paced session that allows five speakers five minutes to speak on the topic of their choice. Topics were submitted from around the world and cover a wide range of non-clinical subjects that reflect the RSNA 2022 theme, Empowering Patients and Partners in Care. Each of the speakers were selected by popular vote.

Exploring the intersection of palliative care and radiology in “Palliative Care in Radiology: More Than Meets the Eye” was the focus for Sam Galgano, MD, section chief of abdominal imaging, director of the abdominal imaging fellowship, and vice chair of quality and patient experience at the University of Alabama at Birmingham. 

He said palliative care is “more than hospice” and requires a multi-disciplinary team, including radiology, to achieve its goal of improving the quality of life for patients. “Throughout the course of patients’ illnesses, they come to the radiology department for imaging and interventions. These services we provide offer promise and optimism, and some of the services we provide offer them relief of their suffering,” he explained. 

He says there are three ways to provide palliative care in patient encounters: Be present in the moment, be human with the patient, and be willing to be emotionally vulnerable. “By doing these things and keeping these things in mind, you're really able to develop a personal relationship with these patients, which will reap great rewards. 

Beth Vettiyil, MD, an assistant professor in skeletal radiology at West Virginia University, discussed increasing patient access to radiologists. She noted that a 2018 study from Emory University published in AJR showed that 96% of patients find direct communication with radiologists helpful. In addition, CMS 2021 allows radiologists to bill for consulting services if there is a physician-patient relationship. To that end, she advocates convening a multi-disciplinary team, including the radiologist, to consult with the patient.

“We can build a brand as radiologists, which means more referrals and more revenue. We can literally step from darkness into light. It will make us irreplaceable. Giving patients increased access to us would help them understand their disease process better, which in turn would empower patients to take responsibility for their medical choices, which could encourage an active patient partnership in their own healthcare,” she said.

In “Compensate Radiologists for Tumor Board Participation,” Sanna Herwald, MD, PhD, a radiology resident at Stanford Medicine, presented five reasons why facilities should establish a payment system for radiologist participation in tumor boards. First, tumor board participation requires significant radiologist effort. For example, during an average week at an academic hospital in Germany, 17 tumor boards require 33 radiologist work hours. 

Second, radiologist participation in tumor boards contributes to patient care. Third, the imaging interpretation and tumor board is an independent contribution, not just a summary of the original read. Fourth, compensation for tumor board participation would likely require documentation, which helps radiologists protect their contributions to the board and ultimately helps patients. 

“Finally, I would like to acknowledge that participating in tumor boards is the right thing to do, regardless of compensation,” she concluded. “But compensation would support radiologists doing the right thing so that tumor board participation becomes more widespread and sustainable.”

Peter Abraham, MD, MAS, a resident physician in the Department of Radiology at the University of California San Diego, discussed achieving health equity and healthcare system transformation through meaningful community engagement and upstream partnerships. Health disparities are not due to individual patient choices or clinical appropriateness, but rather due to the operation of the healthcare system or discrimination in radiology. “As radiologists, we must leave the reading room to investigate the root cause analysis for these existing disparities,” he said.

This includes mitigating transportation challenges, increasing health literacy, addressing childcare and paid time off from work, creating transparency in the financial burden of care, and rebuilding trust in the medical community. “Utilizing a wider community based understanding of health will illuminate some of the upstream factors responsible for our health disparities in our patient populations and provide actionable foci for us to intervene and decrease these disparities,” he explained.

Ali Tejani, MD, a radiology resident at the University of Texas Southwestern Medical Center in Dallas, addressed the concept of bringing patients to the table when discussing how AI is being used in their imaging studies. He referenced a 2021 survey from the Journal of the American Medical Association that showed 90% of patient respondents said they had heard about the important role of AI in their care - but 70% said they were uncomfortable with AI making a decision without an explainable reason. 

“As radiologists, we’re poised to take control of this conversation and serve as stewards of this technology. We have a responsibility to offer trusted evidence and resources for the use of AI in our patients’ care, and to bring their feedback to inform our continued ethical and effective use of AI,” he said.

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